CPT® Code 27147

An osteotomy of the iliac, acetabular, or innominate bone, as described by CPT® Code 27147, is a surgical procedure aimed at correcting congenital malformations of these bones that can lead to hip subluxation or dislocation. This procedure is essential for restoring proper alignment and function of the hip joint. The term 'osteotomy' refers to the surgical cutting of bone, which allows for the reshaping and repositioning of the affected bone structures. In this case, the iliac, acetabular, or innominate bones are specifically targeted to address the underlying issues causing hip instability. The procedure involves careful preoperative evaluation to determine the exact nature of the malformation, followed by the exposure of the bone that requires reshaping. The surgeon marks the planned osteotomy site and makes precise cuts in the bone, enabling the reconfiguration of its shape. If the femoral head is found to be malpositioned, it may be reduced to its proper position before the osteotomy is performed around it. This technique ensures that the reshaped bones can properly conform to the femoral head's size and shape. Additionally, wedges created from the cut bone are strategically placed at the osteotomy sites to maintain the correct angles, and internal fixation devices such as pins, screws, or wires may be utilized to secure the bone in its new position. It is important to note that CPT® Code 27147 should be used when the procedure includes both the osteotomy and the open reduction of the hip, while CPT® Code 27146 is designated for cases involving osteotomy only.